| NPI | 1427636075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MB12768700) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: NJ 25MB1278700) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-11-05 |