NPI | 1558422964 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 229666) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME88479) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2014-07-21 |