| NPI | 1558849596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON PHILIP SHAW Physician Assistant 928-779-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 7036) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |