| NPI | 1447568811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GEORGE SEREDOWYCH Owner 505-982-4276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 2000-289) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2010-09-20 |