| NPI | 1205132032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4151) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 4151) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2023-10-24 |