| NPI | 1184315152 |
|---|---|
| Other Name | LEANDRE D GERVAIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN123399) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2025-01-06 |