| NPI | 1740738533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FESTUS EBONKA President 702-515-9680 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NV APRN000902) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2016-09-21 |