| NPI | 1003785577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WILKINSON Business Operations Director 602-796-2559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |