| NPI | 1962745653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10912000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA10912000) |
| 208000000X Pediatrics (Licence: FL ME 131130) | |
| 208M00000X Hospitalist (Licence: FL ME 131130) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-02-24 |