| NPI | 1003295189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE F MAYES Physician, Owner 702-522-9640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 7200) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |