| NPI | 1346479938 |
|---|---|
| Former Name | MARIAM GUDARZI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS037939) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN18272) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |