| NPI | 1003846932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD067371L) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ 26NR14524400) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2021-04-27 |