NPI | 1417694019 |
---|---|
Entity Type | Organization |
Authorized Contact | TODD RADIVAN Managing Director 702-307-5522 |
Organization Subpart ? | No |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-05-16 |
Last Update Date | 2022-05-16 |