| NPI | 1063073906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS20179) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NJ 25MB11636300) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2023-12-15 |