| NPI | 1609037985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NJ 25MA10217600) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0011454) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2018-01-16 |