NPI | 1679953111 |
---|---|
Former Name | YAZAN JABR |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60724094) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-05-29 |
Last Update Date | 2017-12-07 |