| NPI | 1265232326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORNELL MAURICE CLARK Managing Director 702-904-4077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |