| NPI | 1629092192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 154889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 154889) |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 154889) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-11-17 |