| NPI | 1811085459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK GERARD LONDON Senior Consultant 702-737-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NV 477asc-8) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-10-18 |