| NPI | 1831624352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA10808800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10808800) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2021-11-01 |