NPI | 1225634157 |
---|---|
Entity Type | Organization |
Authorized Contact | EDEN DABALUS Fnp C/ CEO 702-891-0026 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Additional Taxonomies | 251E00000X Home Health |
363L00000X Nurse Practitioner | |
Enumeration Date | 2020-12-07 |
Last Update Date | 2021-04-13 |