| NPI | 1073951687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NJ 25MA10416500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10416500) |
| 207R00000X Internal Medicine (Licence: PA MD457998) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NJ 25MA10416500) | |
| 208M00000X Hospitalist (Licence: PA MD457998) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2020-12-14 |