| NPI | 1003129719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WISSAM A FAYAD Owner 928-344-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 35717) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2022-04-06 |