| NPI | 1518286731 |
|---|---|
| Former Name | SEYED MAHMOUDREZA BEHESHTISHIRAZI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14762) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413472) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2022-06-27 |