| NPI | 1770890220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4110) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH acup-00181) |
| Enumeration Date | 2010-09-04 |
| Last Update Date | 2022-07-21 |