| NPI | 1003010406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 275411) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 004036-1) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2014-10-27 |