| NPI | 1255969267 |
|---|---|
| Other Name | ISMAEL BANLA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MA 1014502) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-06-11 |