| NPI | 1225314966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA09103700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09103700) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2019-04-18 |