| NPI | 1942544432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: OH VET 2985) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: FL VET 1209) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-21 |