| NPI | 1164768461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA09570500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 277211) |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2015-06-16 |