Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 24528 | AZ |
Y | 208600000X | Surgeon | 24528 | AZ |
NPI | 1013065622 |
---|---|
Provider Name | Sumer Louise Daiza |
First Address | Scottsdale, AZ 85255-0122 |
Second Address | Scottsdale, AZ 85254-5216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85183 | (02) |