| NPI | 1689144933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1770) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11000300) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2025-12-05 |