| NPI | 1730961160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA WALKER Manager 702-901-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2024-05-20 |