| NPI | 1437307774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN ELISA ANTTILAINEN Compliance & Credentialing Coor 602-248-0368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X (Licence: AZ CSA08ADHS0187) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2014-01-13 |