| NPI | 1265625297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO ALFONSO AVILES Owner/Physician 307-371-4294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WY 7754A) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2008-02-27 |