NPI | 1235340308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: CA A96161) |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A96161) |
Enumeration Date | 2007-05-24 |
Last Update Date | 2008-07-09 |