| NPI | 1659370146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 137258-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 137258/-1) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2013-10-24 |