| NPI | 1184977555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE V DESJARLAIS CEO 702-415-3463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA1333) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2012-10-22 |