| NPI | 1699162685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 280351) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA12131500) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-07-29 |