Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | R3459 | AZ |
NPI | 1255868451 |
---|---|
Provider Name | Megan Danielle Potilechio |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2017 |
Last Update Date | 20/10/2020 |