| NPI | 1295888709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 221361) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 221361) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2022-09-03 |