| NPI | 1235352147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 42869) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY R1251) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 42869) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-03-05 |