NPI | 1144364795 |
---|---|
Entity Type | Organization |
Authorized Contact | SAMUEL DAVID MCREYNOLDS Physician Assistant 480-860-1045 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 1480) |
Enumeration Date | 2007-02-16 |
Last Update Date | 2016-03-28 |