NPI | 1023852928 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY KARANIUK Credentialing Director 480-447-6841 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
Enumeration Date | 2024-06-24 |
Last Update Date | 2025-01-29 |