Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 51310 | NC |
NPI | 1356939466 |
---|---|
Provider Name | Leen Mohammad Ahmad Alqudah |
First Address | Chapel Hill, NC 27514-4614 |
Second Address | Chapel Hill, NC 27599-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2021 |
Last Update Date | 05/01/2021 |