| NPI | 1407832579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2021012259) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME78560) |
| 208M00000X Hospitalist (Licence: FL ME78560) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2021-07-07 |