| NPI | 1831239508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME122173) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 243059) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME122173) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-11-11 |