| NPI | 1528385614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME119745) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 276764-1) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2017-03-24 |