| NPI | 1912590415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101283102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA12182300) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2025-09-16 |