Name | Value |
---|---|
PROVIDER TYPE | Technologists, Technicians & Other Technical Service Providers |
CLASSIFICATION | Specialist/Technologist, Other |
AREA OF SPECIALIZATION | Illustration, Medical |
STATUS | Inactive |
DATE INACTIVATED | 2023-04-03 00:00:00 |
VA CODE | V150407 |
X12 CODE | 246ZI1000X |
INDIVIDUAL/NON | INDIVIDUAL |
MASTER ENTRY FOR VUID | YES |
VUID | 5255672 |
EFFECTIVE DATE/TIME |
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