NPI | 1801162854 |
---|---|
Entity Type | Organization |
Authorized Contact | ED MATROSE Office Manager 623-362-1818 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 33560) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3855) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP4013) | |
Enumeration Date | 2012-03-23 |
Last Update Date | 2012-03-23 |