| NPI | 1780920645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA09272700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09272700) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2019-01-19 |