NPI | 1073094660 |
---|---|
Entity Type | Organization |
Authorized Contact | GANESH ACHARYA Authorized Official 602-370-0721 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2018-08-22 |
Last Update Date | 2020-04-05 |