| NPI | 1215546932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JOSE Managing Member 702-327-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-01-17 |