| NPI | 1093170011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA KAST Credentialing Manager 602-513-6598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 33212) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |