| NPI | 1972315091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRANAYE ROSE Nurse Practitioner 702-301-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2025-01-24 |
| Last Update Date | 2025-10-21 |