| NPI | 1114476967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-04645) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH ACUP-00211) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2023-02-02 |