| NPI | 1881356954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES MALINIS Credentialing Specialist 702-410-7825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |