| NPI | 1770251068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA FORSTIE Owner/Provider 602-769-1137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |