| NPI | 1043643810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME155918) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD459590) |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: OH 57.247014) | |
| 208000000X Pediatrics (Licence: PA MD459590) | |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2022-08-17 |