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Individual
AMR ESSA
Active
Individual
AMR ESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042.0017846
VT
207R00000X
Internal Medicine Physician
Primary
305727
NY
207RC0000X
Cardiovascular Disease Physician
042.0017846
VT
207RC0000X
Cardiovascular Disease Physician
305727
NY
208M00000X
Hospitalist Physician
042.0017846
VT
208M00000X
Hospitalist Physician
305727
NY
Other
Enumeration date
04/12/2017
Last updated
12/19/2025
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