| NPI | 1831654144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESERIE TSOSIE Credentialing Specialist 602-935-6389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |