| NPI | 1073045597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-52177) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 312696) |
| 208M00000X Hospitalist (Licence: OH 35.13911) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-10-09 |