| NPI | 1316988686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME124926) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D50109) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-08-04 |