| NPI | 1164533642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 128047) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-06-18 |