| NPI | 1619673092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIAGNE ARIELLE R DUAVE CEO 702-969-8785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |