| NPI | 1528187846 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MN 44315) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00043981) | 
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WA MD00043981) | |
| 208000000X Pediatrics (Licence: MN 44315) | |
| 208000000X Pediatrics (Licence: WA MD00043981) | |
| Enumeration Date | 2007-03-28 | 
| Last Update Date | 2020-08-13 |