| NPI | 1861806523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 11745596-1205) |
| Additional Taxonomies | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: UT 11745596-1205) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2021-11-10 |