| NPI | 1194422832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE IRWIN-PODLESNY Founder 505-512-1880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine |
| 261QP2300X Clinic/Center Primary Care | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-01-29 |