| NPI | 1942381611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEISHA R LOPEZ Office Manager 480-751-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 2665) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2023-12-28 |