| NPI | 1487490421 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARLENE REYNOLDS Office Manager 702-886-7075 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family | 
| Enumeration Date | 2024-07-08 | 
| Last Update Date | 2025-02-07 |