| NPI | 1235501370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE C WHITE Cpa Agent 602-222-5611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: AZ 28314) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: AZ 28314) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 28314) | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-12-28 |