| NPI | 1417348244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN J LOPEZ Manager 623-419-2799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7356) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-11-24 |