| NPI | 1649512880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FESTUS EBONKA President 702-515-9680 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |