NPI | 1891980132 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: ME CR1478) |
Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: ME CR1478) |
Enumeration Date | 2007-09-10 |
Last Update Date | 2007-09-10 |