| NPI | 1568942613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELLA CORDOVA Credentialing Manager 623-326-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 3162) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |