| NPI | 1841434537 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: IA 38637)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 38637)  | 
| 208000000X Pediatrics (Licence: TX N2800)  | |
| Enumeration Date | 2009-04-24 | 
| Last Update Date | 2010-02-09 |