| NPI | 1992933956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174M00000X Veterinarian (Licence: NC 7721) |
| Additional Taxonomies | 174M00000X Veterinarian (Licence: CA 17738) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2016-10-01 |