NPI | 1790423358 |
---|---|
Former Name | MHD AGHYAD TARBOUSH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN26982) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-05-24 |
Last Update Date | 2022-07-03 |