| NPI | 1124331103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA SOLUM Administrative Assistant 575-521-4794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2013-01-10 |