Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME86742 | FL |
NPI | 1063469104 |
---|---|
Provider Name | Ayman Alibrahim |
First Address | Lecanto, FL 34460-0127 |
Second Address | Lecanto, FL 34461-8547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 23/04/2009 |