| NPI | 1386267078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN OTA Partner 480-415-5207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 208M00000X Hospitalist | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |