| NPI | 1518063551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06645800) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ 25MA06645800) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2024-06-12 |