| NPI | 1124776018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WOODS Partner 480-209-8599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X |
| 261QM0801X | |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2022-03-10 |