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Individual provider · Student in an Organized Health Care Education/Training Program · Thibodaux, LA

NPI

1073057048

Type

Individual (Type 1)

Primary specialty

Student in an Organized Health Care Education/Training Program

Specialty group

Student, Health Care

Taxonomy code

390200000X

Sex

Male

Sole proprietor

Yes

Enumerated

2016-12-11

Last updated

2016-12-11