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Individual
MITRA DELSHAD
Active
Individual
MITRA DELSHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
123438
OK
363LF0000X
Family Nurse Practitioner
Primary
95004787
CA
363LF0000X
Family Nurse Practitioner
A004603
AR
Other
Enumeration date
04/06/2016
Last updated
04/13/2021
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