| NPI | 1992205512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA M CONNER Office 623-238-8424 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 50572) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA l15479r) |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ D01889748) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |