Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | C35279 | CA |
NPI | 1992822522 |
---|---|
Provider Name | Dr. Robert Brink |
First Address | San Mateo, CA 94402-3125 |
Second Address | San Mateo, CA 94402-3125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 29/01/2009 |