| NPI | 1801136759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25ma09249900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma09249900) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2013-02-28 |