| NPI | 1700129582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: UT 5606688 - 2801) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: UT 5606688 - 8910) |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2013-03-31 |