| NPI | 1811564701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME168293) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME168293) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2024-11-06 |