| NPI | 1255519260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY K BECKER Owner 602-867-1302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 3803) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2020-05-11 |