| NPI | 1902568132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YISEL VIAMONTES-MARRERO President 702-444-7524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |