| NPI | 1548504517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON ZEDEK C.O. 702-489-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV 302f00000x) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |