| NPI | 1740676683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0060861) |
| Additional Taxonomies | 207SG0202X Medical Genetics, Clinical Biochemical Genetics (Licence: CO DR.0060861) |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CO DR.0060861) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2026-08-05 |