| NPI | 1033394861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY NMN DOMER Medical Director 505-783-4045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2008-01-03 |