| NPI | 1902219165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: MI 5101022063) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101022063) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2022-08-19 |