| NPI | 1427377589 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME121484) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2013-00266) | 
| Enumeration Date | 2010-05-27 | 
| Last Update Date | 2014-12-04 |