NPI | 1841553914 |
---|---|
Former Name | HALEH FAZELI-TEHRANI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 103470) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS039609) |
Enumeration Date | 2012-06-22 |
Last Update Date | 2022-03-17 |