| NPI | 1346214236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 175889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 175889) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2011-03-18 |