Individual
BADER M AL ENEZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
04166
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04166
AMERICAN BOARD OF SURGICAL ASSISTANTS
CO
Enumeration date
11/15/2006
Last updated
09/16/2016
Update your record
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