| NPI | 1093012874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FRIDAY Credentialer 702-800-8988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2023-03-23 |