| NPI | 1023296381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY TROY HOLBERT Physician Assistant/ President 623-229-4674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 2021) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2019-08-19 |