| NPI | 1891897757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 231500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 231500) |
| 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: MA 231500) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2013-04-18 |