| NPI | 1316182926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANNE JOHNSTAD Physician Assistant 480-512-3970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 2492) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2009-08-21 |