| NPI | 1346851276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH BANGART Manager 623-230-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |