| NPI | 1932542453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 4376) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH dc4376) |
| 111NN1001X Chiropractor, Nutrition (Licence: OH 4376) | |
| 111NR0400X (Licence: OH 4376) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2024-02-12 |