NPI | 1396253068 |
---|---|
Former Name | PAREESA ARIANA GOSHTASEBI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MT DEN-RDH-LIC-21590) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CO DH.002024978) |
Enumeration Date | 2018-01-16 |
Last Update Date | 2022-11-08 |