| 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 |