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Individual
HAROLD LISANDRO MENDOZA MORENO
Active
Individual
HAROLD LISANDRO MENDOZA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.000377
IL
363AS0400X
Surgical Physician Assistant
Primary
238.000377
IL
Other
Enumeration date
10/04/2013
Last updated
03/19/2024
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