| NPI | 1326707076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA TESSIE BEDUYA-PRINCER CEO 702-902-0225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2021-12-09 |