| NPI | 1013466192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIANA PEREZ Practice Manager 623-505-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2024-12-03 |