| NPI | 1649488420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME98082) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME98082) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2011-10-05 |