| NPI | 1497026405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC STAPE C.E.O./ Owner 505-298-4325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NM bb7316436) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-05-10 |