| NPI | 1134262439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD RUIZ Executive Director 505-526-2935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NM 02401843000) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |