NPI | 1144730607 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE A COO 480-588-3165 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 174400000X Specialist |
207R00000X Internal Medicine | |
251S00000X Community/Behavioral Health | |
261QM0801X | |
Enumeration Date | 2017-10-10 |
Last Update Date | 2022-10-09 |