| NPI | 1235377268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY A PUCKA Owner 505-842-8741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NM 86-107) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-01-29 |