| NPI | 1154498772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME61885) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME0061885) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME0061885) | |
| 208M00000X Hospitalist (Licence: FL ME0061885) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-02-10 |