| NPI | 1831353382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE DIANE LUTGEN Manager 602-795-3371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3608) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2019-04-08 |