| NPI | 1013216134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME124546) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD453143) |
| 208000000X Pediatrics (Licence: MA 281250) | |
| 208M00000X Hospitalist (Licence: FL ME124546) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2026-05-02 |