| NPI | 1881203073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MFON PETER ISEH Owner Of Entity 702-768-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2021-03-23 |