Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1558495945 |
---|---|
Provider Name | Xiao-Jun Ma |
First Address | San Diego, CA 92130-6910 |
Second Address | San Diego, CA 92121-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 15/02/2008 |