| NPI | 1578976619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE GOEDHART Owner 702-682-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN000597) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |