| NPI | 1790050409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BENJAMIN EVANS Owner 602-292-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2024-02-29 |