Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | FL052 | KY |
NPI | 1033572698 |
---|---|
Provider Name | Ahmed Mohamed Elsayed Kassem |
First Address | Louisville, KY 40202-1511 |
Second Address | Louisville, KY 40202-1511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2016 |
Last Update Date | 17/03/2018 |