Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP1135 | AZ |
NPI | 1457387045 |
---|---|
Provider Name | Ms. Cathy Gau |
First Address | Phoenix, AZ 85024-1731 |
Second Address | Phoenix, AZ 85020-2825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
708331 | (05) | AZ |
P63625 | (02) |