| NPI | 1700200953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA09558900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09558900) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2017-12-06 |