| NPI | 1487946679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA A WELLS Director 505-564-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 246QH0600X Spec/Tech, Pathology, Histology | |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2017-06-19 |