| NPI | 1841705340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-04778) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 00201) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2021-05-04 |