| NPI | 1043012263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS GONZALEZ Owner 702-601-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2025-03-26 |
| Last Update Date | 2025-03-27 |