| NPI | 1518946607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MA 220648) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 220648) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2007-07-08 |