| NPI | 1255310330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA05194300) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 186643) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD428130) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2008-02-20 |