| NPI | 1376702035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 248318) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 064603) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2021-03-19 |