Individual
DR. BOSHRA SOPHIA IRAVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
GA1968
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MK97647D
—
NY
Enumeration date
05/20/2015
Last updated
11/15/2024
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