| NPI | 1801316526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: CA A164490) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2017017589) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-07-06 |