Individual
AHMAD ROOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 W 14TH ST, WILMINGTON, DE 19801-1013
(302) 428-6468
Mailing address
501 W 14TH ST, WILMINGTON, DE 19801-1013
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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