Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 006557 | AZ |
NPI | 1023243813 |
---|---|
Provider Name | Dr. Michelle Louise Raphael |
First Address | Gilbert, AZ 85297-0441 |
Second Address | Gilbert, AZ 85234-1610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 22/01/2016 |