| NPI | 1497305627 |
|---|---|
| Former Name | ELAHEHSADAT TABATABAINEJAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 60994106) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401416706) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2023-04-05 |