| NPI | 1215301569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL TROMBLEY Organizer 505-440-8782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 214016) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 214016) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2018-10-17 |