| NPI | 1417118563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPA DHARMARAJAN Owner 623-910-9730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 35176) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2016-07-15 |