| NPI | 1689933301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 52905) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA09155600) |
| 208M00000X Hospitalist (Licence: IA 41900) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2016-07-28 |