Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 19994 | AZ |
NPI | 1124192851 |
---|---|
Provider Name | Daurie Smithline |
First Address | Tucson, AZ 85719-4348 |
Second Address | Tucson, AZ 85719-4348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 27/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E67501 | (02) |