| NPI | 1104857143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WHITE Office Manager 602-443-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 3103) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2010-07-02 |