| NPI | 1174843213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 257773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA062206) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2024-03-07 |