| NPI | 1427635408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN PANGALLO Accounting Manager Credentialing 702-375-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2023-02-28 |