| NPI | 1629871744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARIUS TOLENTINO Managing Member 702-445-4092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RA0201X Internal Medicine, Allergy & Immunology | |
| 207RC0200X Internal Medicine, Critical Care Medicine | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-01 |