| NPI | 1689843278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002385A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 3886) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2022-02-20 |