| NPI | 1497936819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4024) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC27169) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2013-03-29 |