| NPI | 1174753396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBIE RONSMAN Credentialing Administrator 602-308-7815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 37002) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 33804) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2010-07-06 |