| NPI | 1750846549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROYA BEUOKAGHAEI Credentialing Supervisor 702-410-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2023-10-27 |