| NPI | 1396548111 |
|---|---|
| Former Name | CLAY MATTHEW CARREL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |