| NPI | 1558711853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM BORNAEI Owner 505-916-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 01902) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-28 |