| NPI | 1629483920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M WARREN Owner 602-327-7958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5450) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-06-25 |