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Individual
SEPIDEH TARA ROUSTA
Active
Individual
SEPIDEH TARA ROUSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
25MA06717300
NJ
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
25MA06717300
NJ
Other
Enumeration date
01/18/2006
Last updated
04/20/2020
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