Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1629128194 |
---|---|
Provider Name | Robert S Young |
First Address | San Antonio, TX 78254-2455 |
Second Address | Austin, TX 78759-3550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 12/07/2007 |