| NPI | 1346829173 |
|---|---|
| Former Name | KAMRAN KHEDERZADEH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.148228) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U7702) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2024-06-20 |