| NPI | 1700199320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: WI 5831-50) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: MN 00705) |
| 174M00000X Veterinarian (Licence: IL 090.003101) | |
| 174M00000X Veterinarian (Licence: KS 3509) | |
| Enumeration Date | 2010-07-24 |
| Last Update Date | 2010-07-24 |