| NPI | 1144814278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR JEROME HICKS Owner/Authorized Official 775-741-8847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-03-01 |