| NPI | 1114187838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE KAUFMAN Nurse 505-765-5517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |