Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 8990 | AZ |
NPI | 1609326289 |
---|---|
Provider Name | Dien Do |
First Address | Phoenix, AZ 85020-7805 |
Second Address | Phoenix, AZ 85020-2825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2016 |
Last Update Date | 07/10/2016 |