| NPI | 1457881500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 306152) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 74748-20) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2023-01-28 |