| NPI | 1578524062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 3245) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH DC-03245) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2025-03-14 |