| NPI | 1326665803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADA NDULAKA Owner 702-710-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2021-08-27 |