| NPI | 1245586486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-05193) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH10693) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2023-03-03 |