| NPI | 1619378098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANNTEJ SRA CEO 602-529-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2015-01-23 |