NPI | 1104282359 |
---|---|
Former Name | KATAYOON BARADARAN EBRAHIMI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 18004) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2016-01788) |
207W00000X Ophthalmology (Licence: PA MD463064) | |
Enumeration Date | 2016-01-04 |
Last Update Date | 2022-06-13 |