| 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 |