NPI | 1205520376 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL PAUL CARSON Billing Manager 480-626-1415 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2023-06-02 |
Last Update Date | 2023-06-02 |