| NPI | 1609326271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THIERRY DIEZ Owner 702-601-9381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV E0161612016-9) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |