| NPI | 1053539544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA M GOODMAN Medical Director 505-266-3753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2006-0823) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-02-18 |