| NPI | 1023568037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEILAN L DAGUMAN Owner 702-815-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2021-06-11 |