| NPI | 1093246795 |
|---|---|
| Other Name | SEYED JALIL SADRI GHISAR |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 49985) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 49985) |
| 1223G0001X Dentist, General Practice (Licence: CA 49985) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |