| NPI | 1265575062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND P BAKOTIC Medical Director 520-469-7351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 2712) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-01-30 |