| NPI | 1407833817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NT0100X Chiropractor, Thermography (Licence: OH 1201) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 1201) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2019-09-18 |