| NPI | 1447410345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: OH 3903) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 3903) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2021-10-27 |