| NPI | 1154394906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 303059) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 52233) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA05223300) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2025-05-19 |