| NPI | 1174265094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA12726700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA12726700) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2026-09-30 |