| NPI | 1780666057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 80456) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NV 11302) |
| 207R00000X Internal Medicine (Licence: NV 11465) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2025-11-07 |