| NPI | 1700021706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MO 201029319) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD P23802) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2012-10-26 |