| NPI | 1154481984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GODWIN O MADUKA Medical Director 702-880-4193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NV NV20011105262) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NV 2000003 426) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-04-12 |