| NPI | 1336971852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-05365) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH15415) |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2026-07-19 |