| NPI | 1699177477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: MS 2052) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: AL 6328) |
| 174M00000X Veterinarian (Licence: FL 12111) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |