| NPI | 1841801735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH RENEE PREVETTE Member/Medical Practice Manager 602-316-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |