| NPI | 1053402784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA08659900) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD429435) |
| 207R00000X Internal Medicine (Licence: PA MD429435) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2015-04-09 |