| NPI | 1447226741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: LA 022833) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: LA 022833) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2016-12-16 |