| NPI | 1083927347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: MA DL11956) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MA DL10979) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2013-08-01 |