| NPI | 1255976403 |
|---|---|
| Doing Business As | RADIANT ADULT MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JENNIVYR DERAKHSHAN President 928-483-9911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2024-09-13 |