| NPI | 1528180981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME# 0055474) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME#0055474) |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2017-03-23 |