NPI | 1184060287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 174M00000X Veterinarian (Licence: KY NS-KY-2479) |
Additional Taxonomies | 174M00000X Veterinarian (Licence: TN DV0000002873) |
Enumeration Date | 2013-05-15 |
Last Update Date | 2013-05-15 |