Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 49384 | AZ |
N | 2080P0208X | Pediatric Infectious Diseases | 49384 | AZ |
NPI | 1003113531 |
---|---|
Provider Name | Dr. Paulina Elise Mariki-Mhango |
First Address | Peoria, AZ 85345-4603 |
Second Address | Surprise, AZ 85374-4580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2011 |
Last Update Date | 10/03/2016 |