| NPI | 1467882639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4328) |
| Additional Taxonomies | 111NP0017X Chiropractor Pediatric Chiropractor (Licence: OH 4328) |
| 111NS0005X Chiropractor Sports Physician (Licence: OH 4328) | |
| 111NX0100X Chiropractor Occupational Health (Licence: OH 4328) | |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2015-03-04 |