| NPI | 1962420281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 220788-1) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 220788) |
| 207R00000X Internal Medicine (Licence: NJ 25MA07738300) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA07738300) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-08-05 |