| NPI | 1437851417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH CLARK President 602-568-4362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-03-21 |