| NPI | 1902648496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK VICTORINO GOMEZ Owner 702-471-8182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2026-02-12 |