NPI | 1164440608 |
---|---|
Other Name | MOHAMMAD - IZADI |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 11080) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401008006) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2021-11-05 |