| NPI | 1053898833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DEAN OVERLIN Physician Assistant 602-689-9588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 3233) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2024-10-30 |