| NPI | 1578175600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN Z COLON Office Manager 702-772-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-11-11 |