| NPI | 1407035124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD MERLE HATHAWAY Owner 505-345-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NM R 14825) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |