| NPI | 1285861401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA10681900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q0659) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-02-01 |