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 |