NPI | 1497571061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 126800000X Dental Assistant (Licence: TX 136978) |
Enumeration Date | 2024-11-28 |
Last Update Date | 2025-07-20 |