| NPI | 1083447676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL ELDER LORENZO ESCALONA CEO 702-969-4021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2025-01-29 |