Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 8655 | NV |
NPI | 1063587459 |
---|---|
Provider Name | Mr. Shamoon Ahmad |
First Address | Las Vegas, NV 89160-0327 |
Second Address | Las Vegas, NV 89121-3903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F60009 | (02) | NV |