| NPI | 1215504998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA KOZIOL Credentialing Specialist 602-395-0718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-07-07 |