| NPI | 1184147712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH TAM Practice Manager 702-706-2804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002484) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |