| NPI | 1336445618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ME CR2068) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: ME CR2068) |
| 171100000X Acupuncturist (Licence: ME AC385) | |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2023-08-23 |