| NPI | 1942579750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE VINCELETTE Physician Assistant 480-215-3035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 2841) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |