| NPI | 1689105975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA11190000) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 307103) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2021-10-22 |