| NPI | 1649372558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 70270) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA10679000) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 342475-1205) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-06-22 |