NPI | 1124406269 |
---|---|
Entity Type | Organization |
Authorized Contact | WENDI LASHEA GLASON DARAG Md, Owner 575-652-4426 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2013-0836) |
Enumeration Date | 2015-05-08 |
Last Update Date | 2017-10-10 |