| NPI | 1699129510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME140677) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME140677) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2021-08-24 |