| NPI | 1174766778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YURI TALALAEV Doctor 520-393-0898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 28484) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-12-11 |