| NPI | 1649345133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: VA 0101250227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 230712) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 230712) | |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: PA MD468831) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2019-12-12 |