| NPI | 1245686518 |
|---|---|
| Other Name | JAKE A DEVORE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX SA00729) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: KS 142172) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2020-09-10 |