| NPI | 1366469140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK SEBADE Owner 602-564-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 082334) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-08-22 |