| NPI | 1366417677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 162022) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 162022) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ 25MA08425900) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2023-03-07 |