| NPI | 1730333188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA08866000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08866000) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2025-09-09 |