Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 26776 | AZ |
NPI | 1144314089 |
---|---|
Provider Name | Dr. Katherine Rose Daru |
First Address | Phoenix, AZ 85014-5611 |
Second Address | Phoenix, AZ 85012-1839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |