| NPI | 1407488182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WULF Owner 575-208-7795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-05-11 |