| NPI | 1225720907 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | ILYA BENJAMIN Doctor 702-243-7326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-05-26 |