| NPI | 1871596163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: VA 0101222971) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101222971) |
| 207Q00000X Family Medicine (Licence: DE C1-0006197) | |
| 208000000X Pediatrics (Licence: VA 0101222971) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2025-03-18 |