| NPI | 1255714010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENA LATKAS Owner 520-990-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: AZ RN068985) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AZ 86009009) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2016-05-11 |