| NPI | 1891107330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME138041) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME138041) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2025-09-02 |