| NPI | 1669450094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: KY 36029) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 36029) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2013-01-04 |