| NPI | 1730145772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MD461360) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD461360) |
| 208000000X Pediatrics (Licence: CO 35770) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-11-12 |