| NPI | 1942505375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 165728) |
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NY 165728) |
| Enumeration Date | 2011-01-15 |
| Last Update Date | 2011-02-22 |