| NPI | 1568433274 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A055188) | 
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA A055188) | 
| Enumeration Date | 2006-01-30 | 
| Last Update Date | 2010-11-16 |