| NPI | 1942910138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ARES Owner/Provider 702-596-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2023-01-06 |