| NPI | 1275933608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: OH DC4453) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH DC4453) |
| 171100000X Acupuncturist (Licence: OH 65.000287) | |
| 111N00000X Chiropractor (Licence: OH ACUP153) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2021-08-03 |