| NPI | 1881292381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIO ENCABO Manager 702-489-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2021-07-13 |