| NPI | 1790183564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRTA C DALOTTO Owner/Administrator 602-569-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2025-02-21 |