| NPI | 1417440439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11082800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ E50335607408902) |
| 208D00000X General Practice (Licence: NJ 25MA11082800) | |
| 208M00000X Hospitalist (Licence: NJ 25MA11082800) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2021-08-10 |