| NPI | 1518254531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: CA 18323) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: WA VT60109329) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2012-11-14 |