| NPI | 1073825816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN MUNETA Registered Agent 505-554-1786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM MD2007-0072) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-07-09 |