Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | R77254 | AZ |
NPI | 1427519255 |
---|---|
Provider Name | Dr. Daniela Ann Brake |
First Address | Scottsdale, AZ 85259-5499 |
Second Address | Scottsdale, AZ 85259-5499 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2019 |
Last Update Date | 09/09/2020 |