| NPI | 1962624056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EDWARD PREBIL Owner 623-486-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2024-10-30 |