| NPI | 1114216611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 273R00000X Psychiatric Unit (Licence: CA co36013) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA co36013) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |