| NPI | 1366477481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TX G9768) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX G9768) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-10-07 |