Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 34857 | AZ |
NPI | 1497703797 |
---|---|
Provider Name | Christine C Lin |
First Address | Scottsdale, AZ 85255-4351 |
Second Address | Scottsdale, AZ 85255-4351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 11/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
403771 | (05) | AZ |
H69733 | (02) |