| NPI | 1215622600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA13155500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA13155500) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-08-20 |