| NPI | 1780213736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA12149300) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA12149300) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2024-10-12 |