| NPI | 1811108426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N5691) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: TX N5691) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2014-08-29 |