Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 35343 | AZ |
NPI | 1073559621 |
---|---|
Provider Name | Dr. Katharine Dahl |
First Address | Glendale, AZ 85305-2569 |
Second Address | Phoenix, AZ 85016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
145459 | (05) | AZ |
35343 | MEDICAL LICENSE (01) | AZ |