| NPI | 1063535847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: OH 1258) |
| Additional Taxonomies | 111NN1001X Chiropractor Nutrition (Licence: OH 1258) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2013-09-26 |