NPI | 1407833502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 233196) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 233196) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2011-07-16 |