| NPI | 1194491209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE J PANN-NAVA Secretary 505-903-1039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-10-07 |