| NPI | 1386389732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUSLEISY COLLAZO Owner 702-981-4012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2022-04-30 |
| Last Update Date | 2022-04-30 |