NPI | 1932527348 |
---|---|
Entity Type | Organization |
Authorized Contact | CLIFFORD ETIENNE CEO 702-771-0304 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV NV20131689889) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2014-04-02 |