| NPI | 1003218009 |
|---|---|
| Former Name | MOHAMMADREZA KESHMIRI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15696) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15696) |
| 122300000X Dentist (Licence: DC DEN1001440) | |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2015-11-12 |