| NPI | 1073602793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 14785) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND PT14785) |
| 207R00000X Internal Medicine (Licence: NJ 25MA06798300) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-11-28 |