Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 8922 | AZ |
NPI | 1518589647 |
---|---|
Provider Name | Dr. Conner Farrell Bor |
First Address | Chandler, AZ 85226-5940 |
Second Address | Chandler, AZ 85226-5940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2020 |
Last Update Date | 12/05/2020 |