| NPI | 1225457260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOROUZ JOWKAR CEO Medical Director 505-424-9172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2008-0051) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-07 |