| NPI | 1821619867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA DEINET Owner 702-219-6173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |