| NPI | 1073929121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL W LARSON Physician 928-750-8975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 41014) |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2023-03-26 |