| NPI | 1851428312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 851) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: OH 851) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2013-01-08 |