NPI | 1992301881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1326) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 22106) |
Enumeration Date | 2020-12-07 |
Last Update Date | 2024-07-30 |