| NPI | 1366706277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4288) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: OH 4288) |
| 111NR0200X Chiropractor, Radiology (Licence: OH 4288) | |
| 111NR0400X (Licence: OH 4288) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: OH 4288) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2012-06-26 |