| NPI | 1396982419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: PA MD434786) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: OK 26717) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2009-01-12 |