| NPI | 1548497621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB09077400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB09077400) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ 25MB09077400) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2022-03-03 |