| NPI | 1790931426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: CA VET 15864) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: WI 5946-050) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2011-12-29 |