| NPI | 1730702143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA11882200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT220503) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2023-11-28 |