| NPI | 1295477511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTEEN GRIEGO Owner 505-288-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-04-07 |