| NPI | 1841210838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-03255) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OH 33.025140) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2026-02-06 |