| NPI | 1023311784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA ROMO Credentialing Coordinator 775-283-3096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 12752) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2010-12-17 |