| NPI | 1508126038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MB09666100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT014800) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2020-02-06 |