| NPI | 1609025691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA09737000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 43905) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2022-02-01 |