NPI | 1518422583 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANCES MALINIS Credentialing Specialist 702-410-7825 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
207R00000X Internal Medicine | |
Enumeration Date | 2019-02-04 |
Last Update Date | 2019-02-05 |