| NPI | 1689647380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: MO 2023017776) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 205196) |
| 208000000X Pediatrics (Licence: CA A170253) | |
| 208000000X Pediatrics (Licence: MO 2023017776) | |
| Enumeration Date | 2006-02-12 |
| Last Update Date | 2024-05-20 |