| NPI | 1023990140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW GAVIN SCOTT Managing Employee 702-580-7197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |