| NPI | 1386602290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: ME MD22180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD22180) |
| 207Q00000X Family Medicine (Licence: OH 35073229) | |
| 207Q00000X Family Medicine (Licence: MD D80007) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2021-06-17 |