| NPI | 1770119794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NM MD2025-0840) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WI 82405-20) |
| 208000000X Pediatrics (Licence: WI 82405-20) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2025-08-20 |