| NPI | 1972717676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NJ 25MA08285100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 0000000000) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-10-20 |