| NPI | 1912065921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MB07959300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB07959300) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-12-16 |