| NPI | 1932919750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN R TAITANO Practice Owner 702-509-6028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 261QU0200X Clinic/Center Urgent Care | |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2025-02-08 |