| NPI | 1962699512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH E NEUMANN Manager 480-785-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 15963) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 2590) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 151) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |