| NPI | 1518281864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WILKINSON Business Operations Director 702-818-0446 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 5765) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2024-11-11 |