| NPI | 1669865408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMMACULATA INYANG Provider 602-753-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP7650) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |