| NPI | 1033387196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA M HILDRETH Partner 702-445-4943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV 212896) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |