| NPI | 1417629221 | 
|---|---|
| Former Name | DIBA SAGHIZADEH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16260)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 2021011607)  | 
| Enumeration Date | 2021-09-30 | 
| Last Update Date | 2024-09-19 |