| NPI | 1457143505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CHAN Resident Physician 505-803-5758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-05-22 |