| NPI | 1619452968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA VILLASENOR Owner 702-551-2006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |