NPI | 1932648607 |
---|---|
Entity Type | Organization |
Authorized Contact | MAI SHANNON Managing Member 480-359-3998 |
Organization Subpart ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2017-02-15 |
Last Update Date | 2017-02-15 |