NPI | 1932466935 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID DEWAYNE MOON Owner 702-876-2225 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NV 705) |
Enumeration Date | 2012-04-13 |
Last Update Date | 2014-03-31 |