| NPI | 1326423377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN PROSSER Office Manager 702-800-4652 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 12070) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 13914) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |