| NPI | 1861651077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NJ 25MA08832000) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME130583) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: PA MD441409) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2020-02-10 |