| NPI | 1760801047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NE 1447) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 1447) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-06-25 |