| NPI | 1306306857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A179256) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 318524) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A179256) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2026-06-24 |