| NPI | 1518459759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOUHANNAD KANTAR Owner 702-308-6892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2022-02-15 |