| NPI | 1063460939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB03091800) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ XD3165075) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2013-08-15 |