| NPI | 1467405407 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: UT 5400608-1205) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 5400608-1205) | 
| Enumeration Date | 2006-05-19 | 
| Last Update Date | 2022-01-07 |