| NPI | 1366049025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON KULP Owner 623-225-7154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |