| NPI | 1023290616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS CHILDERS Office Manager 505-298-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 207Q00000X) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |