| NPI | 1619948130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA LANGE Npi 928-532-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AZ OTC3497) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ OTC3497) |
| 291U00000X Clinical Medical Laboratory (Licence: AZ OTC3497) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2009-06-11 |