| NPI | 1801105333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ME cr1980) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: ME CRA2265) |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2019-03-27 |