| NPI | 1134550825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WRAY Member 623-399-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 15568) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2014-01-03 |