| NPI | 1184904054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILOMENA E MARCUS Owner 505-293-1658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R25188) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |