| NPI | 1134216617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 232910) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 232910) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 232910) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 232910) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2019-06-13 |