| NPI | 1497453062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNE LEDESMA Authorized Official 505-301-5135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2023-10-06 |