| NPI | 1376631085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11394200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 224207) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 224207) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NJ 25MA11394200) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NY 61-20314) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-04-27 |