NPI | 1437761871 |
---|---|
Former Name | AMANDA GHAFFARI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 110964) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN25189) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2024-12-18 |