| NPI | 1063100394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZAM HAKIM Officer 702-497-5971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |