| NPI | 1417775578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REVELINE GOROSPE Practice Owner 623-680-9038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |