| NPI | 1639550635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WA MD61088338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61088338) |
| 207R00000X Internal Medicine (Licence: MA 264042) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-11-02 |