NPI | 1154569135 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID MESIBOV Medical Doctor 505-661-9637 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM PA2008-0049) |
Enumeration Date | 2009-01-28 |
Last Update Date | 2009-01-28 |