| NPI | 1477633816 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA A101846) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A101846) | 
| Enumeration Date | 2006-10-17 | 
| Last Update Date | 2023-06-13 |