Individual
DIVINE NYAMASOSO MUKIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16630 N 43RD AVE APT 267, GLENDALE, AZ 85306-1543
(319) 383-9411
Mailing address
16630 N 43RD AVE APT 267, GLENDALE, AZ 85306-1543
(319) 383-9411
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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