Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 203975 | CO |
NPI | 1154817666 |
---|---|
Provider Name | Isra E Ahmed |
First Address | Parker, CO 80134-7441 |
Second Address | Aurora, CO 80014-5162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2018 |
Last Update Date | 26/12/2020 |