| NPI | 1639153174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: KY 38828) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 38828) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2022-02-14 |