NPI | 1720577505 |
---|---|
Former Name | OSAMAH AYAD ALRIFAIE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN25441) |
Additional Taxonomies | 122300000X Dentist (Licence: WA 61029044) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-05-07 |
Last Update Date | 2022-10-11 |