| NPI | 1053658625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: FL 31772) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: FL 450718) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |