NPI | 1104111848 |
---|---|
Entity Type | Organization |
Authorized Contact | JR WADE Member 480-229-1986 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP3397) |
Enumeration Date | 2011-06-10 |
Last Update Date | 2011-06-10 |