| NPI | 1528478138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MB09919900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS-1833) |
| 207Q00000X Family Medicine (Licence: CT 73016) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2023-12-28 |