| NPI | 1932087400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICK BURCIAGA COO 702-763-7443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-08-23 |
| Last Update Date | 2025-08-24 |