| NPI | 1972563187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A WYSE President 602-955-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2023-09-28 |