| NPI | 1326850942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK DE JONGH Managing Member 480-912-5456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |