| NPI | 1982194130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 67370) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 67370) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2026-07-01 |