| NPI | 1144724915 |
|---|---|
| Former Name | SEYEDEHSADAF MOSTAFAVIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859129) |
| Additional Taxonomies | 122300000X Dentist (Licence: NH 04680) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2021-11-03 |