| NPI | 1811221054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: OH 35.137166) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.137166) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2022-02-21 |