| NPI | 1669796702 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA08754400) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101247223) | 
| Enumeration Date | 2010-03-18 | 
| Last Update Date | 2014-03-21 |