| NPI | 1174044861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MCDUNN Executive Asistant 702-478-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 261QF0400X) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-07-21 |