| NPI | 1295915346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE WEILER Practice Manager 505-433-2755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM R17788) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NM R17788) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2011-08-12 |