| NPI | 1881196012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY HOLDEMAN Owner 702-433-3038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2018-03-03 |