| NPI | 1013905090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA ONTIVEROS Office Manager 928-581-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207RN0300X Internal Medicine Nephrology |
| 207WX0107X Ophthalmology Retina Specialist | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2023-11-21 |