Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD-001003 | AZ |
Y | 222Z00000X | Podiatrist | POD-001003 | AZ |
N | 213ES0103X | Foot & Ankle Surgery | POD-001003 | AZ |
NPI | 1023515962 |
---|---|
Provider Name | Mahsa Agha Jafari |
First Address | Phoenix, AZ 85012-2677 |
Second Address | Phoenix, AZ 85012-2677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2018 |
Last Update Date | 06/08/2021 |