Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | MD038753L | PA |
NPI | 1477589521 |
---|---|
Provider Name | Simindokht Dadparvar |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0009833160010 | (05) | PA |
C34217 | (02) |