| NPI | 1588124994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042.0016070) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 341865) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0016070) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2026-04-07 |