| NPI | 1497021679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEQUA SALEHI-RAD Owner/Member 928-669-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 5436) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 5436) |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2012-04-01 |