| NPI | 1164315560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIKA UGORJI Administrator/CFO 928-951-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207Q00000X Family Medicine | |
| 208000000X Pediatrics | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-06-02 |