NPI | 1780373183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019.034529) |
Enumeration Date | 2023-05-02 |
Last Update Date | 2024-05-13 |