Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | LT3226 | NH |
NPI | 1013142959 |
---|---|
Provider Name | Dr. Maria Michelle Diaz |
First Address | Hampton, NH 03842-2222 |
Second Address | Derry, NH 03038-2746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 03/12/2012 |