| NPI | 1437509155 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TX UO819) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301110482) | 
| Enumeration Date | 2016-06-14 | 
| Last Update Date | 2022-12-05 |