| NPI | 1851110837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CLYDE MANALILI CFO 702-703-1668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-11-19 |