| NPI | 1770990004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MA 269493) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MA L-259280) |
| 207R00000X Internal Medicine (Licence: MA 269493) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2017-03-28 |