| NPI | 1922643261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIR BACCHUS Cmo 702-910-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208D00000X General Practice | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2020-09-22 |