Individual
ILILLII HISSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 E IRWIN AVE, PHOENIX, AZ 85042-5699
(602) 531-3888
Mailing address
1220 E IRWIN AVE, PHOENIX, AZ 85042-5699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
261063
AZ
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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