| NPI | 1912169319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: VA 0101246407) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101246407) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2016-03-30 |