| NPI | 1053883306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ELISE LOPEZ Owner 575-621-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2021-08-02 |