| NPI | 1184733719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-02547) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH ACUP-00196) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-10-21 |