| NPI | 1467652289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL M ELLISON Practitioner 505-522-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NM R32956) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2014-10-23 |