NPI | 1659705762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN514) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 020577) |
Enumeration Date | 2013-08-26 |
Last Update Date | 2023-10-06 |