| NPI | 1346512977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4111) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: OH 4111) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |