| NPI | 1164176327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REYNANTE VILLAHERMOSA Nurse Practitioner 702-885-6457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |