| NPI | 1124111901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN BRUCE KIDMAN President Owner 505-795-7370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NM MD2006-0557) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2014-07-07 |