| NPI | 1710681184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA13059500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA13059500) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2026-07-31 |