| NPI | 1841376126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN E. HERTEL Phycisian Assistant 480-229-7651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3065) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2019-08-09 |