| NPI | 1972571313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 34022) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 34022) |
| 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: WI 34022) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2018-05-17 |