| NPI | 1629273255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: PA MD434596) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CA A92217) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2011-05-27 |