| NPI | 1699906354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09222300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD446476) |
| 208M00000X Hospitalist (Licence: NJ 25MA09222300) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2023-05-02 |