| NPI | 1689280026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE HANTA WALLISCH Chief Executive Officer 702-355-9862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-22 |