| NPI | 1578947230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10258000) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA10258000) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2022-08-09 |