| NPI | 1841613650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMMON WILCOX Medical Director 702-785-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NV 11588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2009007880) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: PA MD033724E) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: UT 6968998-1205) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 11588) | |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2014-01-30 |