| NPI | 1720608300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MN 76221) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 8293) |
| 207Q00000X Family Medicine (Licence: WI 76202) | |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2024-06-18 |