| NPI | 1649516477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: NJ 29VI0060600) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: PA BV012387) |
| 174M00000X Veterinarian (Licence: NY 010397) | |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |