Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 59056 | AZ |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD1855902 | OR |
NPI | 1033524012 |
---|---|
Provider Name | Shaili Gal |
First Address | Scottsdale, AZ 85251-3119 |
Second Address | Mesa, AZ 85202-4736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2014 |
Last Update Date | 05/10/2020 |