| NPI | 1902534316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAMILKA CASTILLO GONGORA Owner Provider 702-623-8651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2023-08-23 |