| NPI | 1851152094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NH 1227) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA CHI3851) |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2025-05-14 |