| NPI | 1841561859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DAVID KENNEDY President 602-320-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 2765) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-06-28 |