| NPI | 1023158268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NH 21459) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NH EL05710) |
| 207R00000X Internal Medicine (Licence: NY 180323) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2025-12-12 |