| NPI | 1285619155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 31636) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 31636) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2025-09-11 |