| NPI | 1144890104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MB12306000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT020680) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-07-12 |