| NPI | 1740481837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALE LYNN KOCH Owner 702-492-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NV apn000878) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |