| NPI | 1164694642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME109043) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 109043) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2026-01-27 |