| NPI | 1700266939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS025289) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MB12068500) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2025-10-30 |