| NPI | 1336128198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 177089) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 036100) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2013-10-16 |