| NPI | 1932462397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: PA OS020721) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NJ 25MB09676000) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2020-10-20 |