| NPI | 1194997262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LORRAINE TRAIKOVICH Administrator 602-317-9347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2019-09-27 |