Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 2939 | NV |
NPI | 1437211455 |
---|---|
Provider Name | Ramin Homanfar |
First Address | Reno, NV 89511-2062 |
Second Address | Reno, NV 89511-2062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 08/07/2007 |