NPI | 1699538116 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY ROE Owner 702-860-9179 |
Organization Subpart ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-02-06 |
Last Update Date | 2024-02-06 |