| NPI | 1164892782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: UT 9053222-2801) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: NV 2264) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-11-25 |