| NPI | 1194047282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WILLIAM STARK President 702-250-9022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA1068) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1068) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |