Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 29841 | AZ |
NPI | 1104801471 |
---|---|
Provider Name | Dr. Rosanne Marie Kho |
First Address | Phoenix, AZ 85054-4502 |
Second Address | Phoenix, AZ 85054-4502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 30/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
626195 | (05) | AZ |
86080015085259A742 | TRIWEST (01) | AZ |
86080015085260A088 | TRIWEST (01) | AZ |
F59996 | (02) |