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 |