| NPI | 1366985301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA HAMELIN Credentialing Coordinator 602-308-7817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ 15563) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 15563) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |