| NPI | 1770546855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MA 158242) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 158242) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2015-08-25 |