Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1951DT | KY |
NPI | 1003224809 |
---|---|
Provider Name | Bilal Ahmad |
First Address | Lexington, KY 40516-9719 |
Second Address | Lexington, KY 40516-9719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 24/07/2014 |