| NPI | 1750990503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIAGNE ARIELLE DUAVE CEO 702-588-1938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2021-06-10 |