| NPI | 1942563994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA09620500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201654) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2018-03-17 |