Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | D2220 | ZZ |
NPI | 1558681098 |
---|---|
Provider Name | Dr. Berni Massari |
First Address | Mesa, AZ 85206-5235 |
Second Address | Mesa, AZ 85206-5235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2010 |
Last Update Date | 29/04/2011 |