Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1205591542 |
---|---|
Provider Name | Lama Ahmad |
First Address | Dearborn, MI 48124-2044 |
Second Address | Dearborn, MI 48124-2044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2021 |
Last Update Date | 02/11/2021 |