| NPI | 1902009459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA08471100) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD434982) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 254294-1) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2021-06-09 |