| NPI | 1609370089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA11115900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11115900) |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NJ 25ma11115900) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2022-10-25 |