| NPI | 1972506749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NJ 25MA09294600) | 
| Additional Taxonomies | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NY 215012) | 
| Enumeration Date | 2005-05-24 | 
| Last Update Date | 2013-05-30 |