| NPI | 1053385609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 17848) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME142315) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME142315) | |
| 208M00000X Hospitalist (Licence: AZ 17848) | |
| 208M00000X Hospitalist (Licence: FL ME142315) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-03-09 |