| NPI | 1407190473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN REDUS Sole Member 480-596-8525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 2477) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |