| NPI | 1851690614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WA MD60391410) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60391410) |
| Enumeration Date | 2011-03-19 |
| Last Update Date | 2018-10-02 |