| NPI | 1013249838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 25MA11879900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01075433A) |
| 207Q00000X Family Medicine (Licence: TX N9976) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX N9976) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 01075433A) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2024-04-02 |