| NPI | 1164930491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN OWYONG Credentialing Contact 702-802-3456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2022-10-25 |