| NPI | 1689687287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-02156) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0070905) |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MD D0070905) | |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NC 2013-02156) | |
| 208000000X Pediatrics (Licence: MD D0070905) | |
| 208000000X Pediatrics (Licence: NC 2013-02156) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-04-29 |