NPI | 1437308616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080T0002X Pediatrics, Medical Toxicology (Licence: NJ 52397) |
Additional Taxonomies | 2083T0002X Preventive Medicine, Medical Toxicology (Licence: NJ 25MA05239700) |
207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 152780) | |
Enumeration Date | 2008-09-12 |
Last Update Date | 2023-10-17 |