NPI | 1437314879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN56) |
Additional Taxonomies | 208D00000X General Practice (Licence: WA 21215) |
208D00000X General Practice (Licence: LA 07907R) | |
Enumeration Date | 2008-07-24 |
Last Update Date | 2008-07-24 |