| NPI | 1013794791 |
|---|---|
| Other Name | TAREQ KHADRA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 109296) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00205725) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2025-03-06 |