| NPI | 1164521084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA04844900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101037485) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ 25MA04844900) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-08-03 |