| NPI | 1821092594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: OH 1574) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 1574) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-01-09 |