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 |