| NPI | 1568801777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL 128690) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ V02216807408862) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2016-07-07 |