| NPI | 1568221885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKEOMA I COOPER Owner 575-571-6946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-07-30 |