| NPI | 1831530872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: CA 6312) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: ID V-1114) |
| 174M00000X Veterinarian (Licence: UT 6694020-2801) | |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2013-07-06 |