NPI | 1689242190 |
---|---|
Entity Type | Organization |
Authorized Contact | RILWAN OLALEKAN SHOYOMBO President/Provider 702-846-5978 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2021-06-12 |
Last Update Date | 2021-07-24 |