| NPI | 1063788701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA KAWIKA PEIPER Chief Operating Officer 505-433-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NM FA01022864) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |