| NPI | 1124592761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA M GONZALES Owner 505-304-9381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |