| NPI | 1891905006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER ALENE WALLIS Office Manager 480-905-9211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 23958) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2008-06-22 |