| NPI | 1851383285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: ME cr1921) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: VT 006.0092403) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2018-08-06 |