| NPI | 1164631701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA MARIE FERRALES Credentialing 505-647-8366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 90-15) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-10-27 |