| NPI | 1487389136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSIAH H CHILD Owner 505-603-5324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2024-06-03 |