| NPI | 1881768315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 2082) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 65000035) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2011-10-18 |