| 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 |