| NPI | 1164276804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH FISHER Board 702-769-7087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |