| NPI | 1467850461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL ORTIZ Member 928-539-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |