| NPI | 1720023971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD428153) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 221806) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA07961500) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD428153) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2011-01-12 |