| NPI | 1891778296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 241532) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A64121) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 241532) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2022-03-08 |