| NPI | 1306249420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN E MEYER Physician Assistant 480-376-4494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 5499) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |