| NPI | 1619323045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD DISHON Partner/Member 623-218-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |