| NPI | 1629237235 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 266022)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 266022)  | 
| Enumeration Date | 2008-06-09 | 
| Last Update Date | 2023-07-03 |