| NPI | 1982920328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NY 256609) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 256609) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 256609) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2021-02-05 |