| NPI | 1902298243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS AMPONG KODJOE Practice Owner 702-241-8721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 13300) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2016-03-18 |