| NPI | 1225218951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C GONZALEZ Owner 702-610-5458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 4480) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2007-11-09 |