| NPI | 1346622305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA 7474657) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2016-08-12 |