| NPI | 1376507616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL J GIANGOBBE President 623-584-7874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 23204) |
| Additional Taxonomies | 2086S0129X (Licence: AZ 23204) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-10-29 |