| NPI | 1841831146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 21556) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2023-12-28 |