| NPI | 1184985475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN L ROBERTS Practice Manager 505-436-2906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2012-06-03 |
| Last Update Date | 2013-04-21 |