| NPI | 1053429829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 214279-1) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 2142791) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-03-13 |