| NPI | 1508108721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: FL VM13528) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: CO VET.0009655) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2015-08-11 |