| NPI | 1558560110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VT 042.0019234) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 2569371) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2026-08-26 |