| NPI | 1871291112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 170300000X Genetic Counselor, MS (Licence: MI 7201000362) |
| Additional Taxonomies | 170300000X Genetic Counselor, MS (Licence: CT 351) |
| 170300000X Genetic Counselor, MS (Licence: FL 348) | |
| 170300000X Genetic Counselor, MS (Licence: MT GEN-GEN-LIC-000467) | |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-02-16 |