| NPI | 1811191679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NC 2013-01999) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD440084) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2013-12-17 |