| NPI | 1104572700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL DAWN GARMAN Credentialer 775-302-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2025-10-28 |