| NPI | 1861127870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA BETANCOURT-SANCHEZ Authorized Official/Owner 702-209-3417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2022-07-22 |
| Last Update Date | 2022-07-22 |