| NPI | 1114602794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALEINA BULGER Credentialing Manager 602-457-7300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-06-20 |