| NPI | 1558693689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN CHAN Member 505-298-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 2000-157) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |