| NPI | 1720383508 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TERESA DE PERALTA President 702-321-6459 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NN09621900) | 
| Enumeration Date | 2011-01-25 | 
| Last Update Date | 2011-01-25 |