| NPI | 1134654866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK QUIAMZON Owner/Nurse Practitioner 702-499-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |