Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 338108 | NY |
NPI | 1003248402 |
---|---|
Provider Name | Ira Eunice Arandia Mauro |
First Address | Scottsdale, AZ 85258-5199 |
Second Address | Scottsdale, AZ 85258-5199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2013 |
Last Update Date | 19/06/2017 |