| NPI | 1376624635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: WA MD00008915) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00008915) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2014-12-18 |