| NPI | 1750791166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME144389) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME144389) |
| 208M00000X Hospitalist (Licence: NJ 25MA10189000) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2025-08-12 |