| NPI | 1144715129 |
|---|---|
| Former Name | SHABNAM ESLAMFAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 34180) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 34180) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-11-01 |