| NPI | 1912003054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT W SPARKS Administrator 702-813-7701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV P07-02616-B-102535) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2023-12-05 |