| NPI | 1477920692 |
|---|---|
| Professional Name | FRED FAZLOLLAH MOVA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A36079) |
| Additional Taxonomies | 261QC1800X Clinic/Center, Corporate Health (Licence: CA A36079) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |