| NPI | 1952638660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY L WALLACE Office Administrator 928-726-0985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: AZ 13856) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |