| NPI | 1972612737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME60101) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME60101) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2014-06-06 |