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 |