Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 06-911 | AZ |
NPI | 1033242045 |
---|---|
Provider Name | Dr. Nael Dagstani |
First Address | Lake Havasu City, AZ 86403-5653 |
Second Address | Lake Havasu City, AZ 86403-5653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 06/03/2020 |