NPI | 1427367077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN765) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 18015) |
Enumeration Date | 2010-09-30 |
Last Update Date | 2018-10-24 |