NPI | 1356817332 |
---|---|
Entity Type | Organization |
Authorized Contact | AMIR BACCHUS Cmo 702-910-3950 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
208D00000X General Practice | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2018-10-17 |
Last Update Date | 2021-02-09 |