| NPI | 1255771606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA10746300) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: PA MT205171) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2020-03-05 |