| NPI | 1891826202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101242169) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 241718) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 241718) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2014-04-16 |