| NPI | 1619979697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NY 193350) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 193350) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-05-21 |