NPI | 1639545007 |
---|---|
Entity Type | Organization |
Authorized Contact | COLLEEN LITTLE Clinical Manager 928-779-3366 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP8048) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2015-08-19 |