| NPI | 1518796770 |
|---|---|
| Former Name | JACK ROBERT SPARAGNA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 390200000X) |
| Enumeration Date | 2024-07-27 |
| Last Update Date | 2024-10-17 |