| NPI | 1922669803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA11846700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 326293) |
| Enumeration Date | 2019-06-22 |
| Last Update Date | 2026-06-30 |