Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | PTA-013956 | AZ |
NPI | 1285219675 |
---|---|
Provider Name | Aaron Aschendorf |
First Address | Phoenix, AZ 85037-1229 |
Second Address | Phoenix, AZ 85037-1229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2021 |
Last Update Date | 16/03/2021 |