| NPI | 1417966219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME107485) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MO 2002014672) |
| 208000000X Pediatrics (Licence: MO 2002014672) | |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: FL ME107485) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2014-10-15 |