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Individual

ROHAM MOFTAKHAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036-129390
IL
207T00000X
Neurological Surgery Physician
Primary
37893
SC
207T00000X
Neurological Surgery Physician
47499
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
378932
SC
Enumeration date
04/19/2006
Last updated
03/22/2018
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