| NPI | 1730560988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MB10159800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB10159800) |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2020-10-18 |