| NPI | 1366127789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUSIMI LOPEZ RAMOS Owner 702-510-9587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-07-11 |