NPI | 1679379572 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTIN PEDRAZA Member 702-629-0245 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2025-02-21 |
Last Update Date | 2025-03-24 |