| NPI | 1184004400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY 58893) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 56865) |
| 207R00000X Internal Medicine (Licence: NY 309448) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 56865) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2025-08-27 |