NPI | 1083356588 |
---|---|
Entity Type | Organization |
Authorized Contact | JAVIER HERNANDEZ ESTRADA Owner 702-903-5124 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2022-04-13 |
Last Update Date | 2022-04-13 |