| NPI | 1538421672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC4208) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 4208) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2016-04-26 |