| NPI | 1336143072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 3637) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 65.000128) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2008-09-29 |