| NPI | 1710392717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA10154800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7178) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2020-11-24 |