| NPI | 1760575815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ACN986) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN986) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2025-11-05 |