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Individual
ALEXANDER REAL
Active
Individual
ALEXANDER REAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S37078985
RMV LICENSE
MA
Enumeration date
05/16/2022
Last updated
05/16/2022
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