| NPI | 1760426555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA07666800) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07666800) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-03-17 |