| NPI | 1205092426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10727000) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 290873) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA10727000) | |
| 174H00000X Health Educator | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2024-04-26 |