| NPI | 1083984694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN WISTER Owner 520-335-6271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP3956) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2020-07-16 |