| NPI | 1801101431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AR E-15605) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-15605) |
| 207R00000X Internal Medicine (Licence: OH 099803) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA10242500) | |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2022-09-12 |