| 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 |