NPI | 1205462322 |
---|---|
Former Name | JEREMIE MATTHEW LEVER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: AL .) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-20 |
Last Update Date | 2022-09-10 |