Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 50181 | AZ |
NPI | 1093008336 |
---|---|
Provider Name | Amber L Flaherty |
First Address | Atlanta, GA 30368-7287 |
Second Address | Phoenix, AZ 85028-3091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2011 |
Last Update Date | 12/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017816 | (05) | AZ |