| NPI | 1508421819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONI B PRUCZ Managing Partner 480-625-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |