| NPI | 1023249042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN MARIE WEAVER Member 928-257-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: AZ 33312) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: AZ 33312) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2019-08-15 |