| NPI | 1306475181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MESKELO BOBO Owner 702-849-3302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2022-10-11 |