| NPI | 1427390194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN KANAKA Practice Manager 602-457-7312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: AZ AZ02363) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |