| NPI | 1285746404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN201) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL ACN201) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2025-04-15 |