| NPI | 1699922369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WI 3675) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091882) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2024-01-11 |