| NPI | 1841432911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: NY 010783-1) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: NJ 29VI00471400) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2014-07-29 |