| NPI | 1295143709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BESCHELLE JUANMIA LOCKHART Owner 702-209-0370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2024-03-07 |