| NPI | 1699867861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 471) |
| Additional Taxonomies | 170100000X Medical Genetics, Ph.D. Medical Genetics (Licence: TN PA0471) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-12-16 |