| NPI | 1851057194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: NY 013636) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: CT 5392) |
| 174M00000X Veterinarian (Licence: FL VM19290) | |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2026-04-29 |