| NPI | 1396723144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1380) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 11230) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2021-11-02 |