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 |