Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 12-1317 | AZ |
N | 175L00000X | Homeopath | 12-1317 | AZ |
NPI | 1326392697 |
---|---|
Provider Name | Dr. Nanao Takaki |
First Address | Sun City, AZ 85351-1344 |
Second Address | Sun City, AZ 85351-1344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2012 |
Last Update Date | 07/11/2012 |