| NPI | 1093046963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY JAMES VAN VLEET Physician Assistant 702-614-4178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2010-01-16 |
| Last Update Date | 2010-01-16 |