Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 35.077542 | OH |
Y | 2080P0201X | Pediatric Allergist | 36281 | AZ |
NPI | 1891744348 |
---|---|
Provider Name | Mr. Michael Owen Daines |
First Address | Tucson, AZ 85756-7214 |
Second Address | Tucson, AZ 85711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 29/05/2013 |