| NPI | 1154918019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 05028) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH ACUP-00227) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2024-05-16 |