| NPI | 1487949418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: OH 35.137263) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.137263) | 
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.137263) | |
| Enumeration Date | 2011-06-17 | 
| Last Update Date | 2024-11-19 |