| NPI | 1407483639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MESHEA KATELYN KROL Credentialing Assistant 602-577-7914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |