Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 07-1040 | AZ |
NPI | 1043494552 |
---|---|
Provider Name | Dr. David Hagen |
First Address | Scottsdale, AZ 85253-4555 |
Second Address | Scottsdale, AZ 85253-4555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2007 |
Last Update Date | 19/12/2007 |