NPI | 1194596817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: ME CR2974) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: ME CR2974) |
Enumeration Date | 2024-01-11 |
Last Update Date | 2024-07-17 |