| NPI | 1669529186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 158288) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 41410) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2010-05-11 |