| NPI | 1801047667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA09137900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 60263135) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2013-11-18 |