| NPI | 1023250339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WHITE Supervisor 602-443-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 22382) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2010-07-01 |