| NPI | 1255389813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA0726100) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ XA9072240) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-07-07 |