| NPI | 1447662788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-04806) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002766a) |
| 111N00000X Chiropractor (Licence: FL CH12554) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-09-22 |