| NPI | 1831185222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 165144) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 165144) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2013-02-06 |