| NPI | 1720284334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ZLAKET-MATTA Medical Director President 480-219-5597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 23480) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2011-06-27 |