| NPI | 1609570811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA12945400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA12945400) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2026-08-20 |