| NPI | 1073910873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MARIE DEROSA Owner 480-619-4097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 4223) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2020-01-30 |