| NPI | 1568777316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: NJ 25MA09493900) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 271297) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2016-11-29 |