| NPI | 1033214358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: NY 135661) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 135661) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |