| NPI | 1184211237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 05029) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH ACUP-00207) |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2021-10-21 |