| NPI | 1063771830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME151877) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 280216) |
| 208M00000X Hospitalist (Licence: NJ 25MA10074600) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2021-08-26 |