| NPI | 1528243870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: VA 0101249389) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 141802) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101249389) | |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2013-08-01 |