| NPI | 1528352457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE TRUJILLO Owner 505-508-5398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP01205) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2011-06-08 |