| NPI | 1669507588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA07658700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07658700) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D67789) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 282598) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2022-06-14 |