Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 32317 | AZ |
NPI | 1417904038 |
---|---|
Provider Name | Khajista Qazi |
First Address | Phoenix, AZ 85034-7256 |
Second Address | Phoenix, AZ 85008-4973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 11/06/2012 |