| NPI | 1649774563 |
|---|---|
| Former Name | SOORENA MOGHADDAM ZADEH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2020-11-03 |