| NPI | 1790939148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 16639) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NJ 25MA08790400) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2022-09-08 |