| NPI | 1932454592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH DC-04316) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 10686) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2024-07-09 |