Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 30712 | AZ |
NPI | 1073621801 |
---|---|
Provider Name | Dr. Holly Ahner |
First Address | Tucson, AZ 85745-9773 |
Second Address | Tucson, AZ 85723-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Z74559 | (02) | AZ |