| NPI | 1306245998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDLA A GERNER Vice President/Office Manager 505-699-8064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NM 90-196) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NM 90-196) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2022-07-19 |