| NPI | 1346235926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA06374000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA06374000) |
| 208D00000X General Practice (Licence: NJ 25MA06374000) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2016-01-26 |